Fertility Research ‘Long Overdue’ for Patients With Cervical Cancer

For patients with cervical cancer who are negative for high-risk human papillomavirus (HPV) with normal or low-grade cytology, a prolonged follow-up interval of six months could be offered six to 24 months after receiving fertility-sparing surgery, according to the findings of a recent study.

Researchers, writing in a study published in The Lancet Oncology, noted that patients who are negative for high-risk HPV and have normal or low-grade cytology — a type of screening that collects cervical cells to be checked for changes caused by HPV that may turn into cancer, as explained by the National Cancer Institute — make up 80% of patients who receive fertility-sparing surgery, and that a 12-month interview “seems to be safe” following two consecutive negative high-risk HPV tests and an absence of high-grade cytology, which applies to 75% of all patients who receive fertility-sparing surgery.

Current guidelines in both the United States and Europe, researchers explained, recommend a six- to 12-month interval between follow-up visits for two years after fertility-sparing surgery, with a total follow-up of five years.

Learn more: HPV Causes Multiple Cancers, Though Knowledge on the Connection Is Lagging

“The development of a tailored surveillance strategy after fertility-sparing surgery could contribute to improved efficiency of follow-up in patients with cervical cancer and subsequently reduce costs in health care,” wrote the researchers behind the population-based retrospective cohort study, which utilized data from the Netherlands Cancer Registry and the Dutch Nationwide Pathology Data Bank on more than 1,400 patients ages 18 to 40 with cervical cancer who received fertility-sparing surgery between Jan 1, 2000 and Dec 31, 2020.

“It's always been really just (about) luck of the of the draw in who your oncologist is and who your team of doctors are to even discuss your fertility," Kate Weissman said.

Photo couresy of Cervivor, Inc.

Kate Weissman, a cervical cancer survivor, welcomes such research advancements.

“(It's) well overdue and certainly something that the cervical cancer community is owed, given that it's something that has not been paid attention to for so long,” she said. “It's always been really just (about) luck of the of the draw in who your oncologist is and who your team of doctors are to even discuss your fertility. So, I think that this is really long overdue, and I'm glad that the attention is on it, finally, for women.”

When Weismann received a diagnosis of stage 2B cervical cancer in 2015 at the age of 30, two years after being diagnosed with HPV, she was also told by her oncologist that she would not be able to carry children.

Kate began IVF, froze nine embryos and received treatment via 55 rounds of radiation, 17 rounds of chemotherapy and surgery before being declared cancer-free in 2016. She and her husband, Matt, eventually had a daughter, Louella, via surrogacy.

Now an ambassador for Cervivor, a community of patient advocates working with those affected by cervical cancer, and a 2023 Cervivor Champion Recipient, Weissman is also the Massachusetts State Lead Ambassador for the American Cancer Society Cancer Action Network.

Learn More: Why Patients Need to Remain Vigilant, Even When Dealing With Scanxiety

“When I ended my treatment in 2016, I was initially going for scans every three to six months. And then, after a couple of years, I was slowly able to extend those scans out, so now I go annually,” she said. “I will tell you, the anxiety is always with you. It never loosens its grip; you are always worried about (the cancer) coming back. And even though I'm lucky to only have to deal with scanxiety — as we call it in the cervical cancer community and really the cancer community in general once a year — it's really intense and I still have to keep up-to-date on my antianxiety medications and my therapy sessions and everything.

“Now that I have a child it's really made that anxiety of the cancer coming back all that more intense, and it feels like a lot more is at stake. But I am lucky that I survived, and it's a once-a-year thing for me. … I have access to a medical team that is going to always watch me and look out for me, and I'm aware of my own body and everything I need to be on the lookout for too in the years post-treatment. So, that's been certainly something that it never loosens its grip on you. Even when you find out (that) you're cancer-free, you're in this for the rest of your life.”

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